4/8/2016. This knowledge based activity is accredited for 1.0 contact hour Target audience: Certified Pharmacy Technicians (CPhT)

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1 This knowledge based activity is accredited for 1.0 contact hour Target audience: Certified Pharmacy Technicians (CPhT) By Della Ata Khoury, CphT, BS, BA, MA Pharmacy Technician Instructor at LARE Institute PTEC, MSHP No relevant financial relationships to disclose Describe how the pharmacy technician position evolved Identify requirements for educational training programs as recommended by ASHP Recognize the requirements for the PTCE and the ExCPT national certifications Recognize the outcome of the PTCB C.R.E.S.T summit and its implications Identify developments in the pharmacy technician field Recognize the importance of education and training in saving lives 1930s: Medics enlisted in the military served as pharmacy technicians 1958: Training programs introduced by the military 1970s: Training programs proliferated 1975: Training guidelines were created by ASHP for hospital support personnel a) Military personnel b) Relatives of pharmacists c) Nurses d) Apothecaries 1979: Massachusetts College of Pharmacy established a pharmacy technician training program 1982: Standards for pharmacy technician training programs were created by ASHP 1983: ASHP accredits the 1 st technician training program in Pennsylvania 2002: ~247 training programs in 42 states 1

2 The counting and pouring now often alleged to be the pharmacist s chief occupation will in time be done by technicians and eventually by automation. The pharmacist of tomorrow will function by reason of what he knows, increasing the efficiency and safety of drug therapy and working as a specialist in his own right. It is in this direction that pharmaceutical education must evolve without delay. Linwood F. Tice, D.Sc., Dean, Philadelphia College of Pharmacy and Science (1966) 1987: ASHP council on educational affairs recommended a national voluntary certification program 1993: ASHP approves a resolution supporting registration and certification 1995: PTCB created 1996: White paper on pharmacy technicians developed (updated in 2002, needed changes can no longer wait) 2001: Increase in number of states requiring registration; 24 states required registration and 5 required licensure (registration) versus 14 states in : ExCPT was granted accreditation by National commission for Certifying Agencies (NCCA) : 11 terms used to refer to pharmacy technicians, only 24 states used the term pharmacy technician Pharmacy supportive personnel Pharmacy aide Pharmacy clerk Pharmacy assistant Pharmacy helper 2001: 38 states adopted the designation Pharmacy technicians assist licensed pharmacists by performing duties that do not require the professional skills and judgment of a licensed pharmacist and assisting in those duties that require the expertise of a pharmacist. White Paper, 2002 Minimum of 600 hours extending over 15 weeks or more Didactic training (~160 hours) Pharmacology Pharmacy Law & Ethics Medication Calculation Medical terminology Pharmacy software management Simulated experience (~80 hours) Experiential training (~160 hours) in at least 2 different pharmacy settings 2

3 a) Didactic training in pharmacology b) Nine 4-week rotations of experiential training c) Simulated experience d) Knowledge of medical terminology Requirements for entry into the workforce Education and training Registration and certification Titles and functions performed Knowledge and skills It is ironic that persons in certain other occupations whose services have far less impact on public safety than do those of pharmacy technicians (e.g., barbers and cosmetologists) have training programs that, on average, are longer and less diverse than are pharmacy technician programs Pharmacist shortage Emphasis on pharmaceutical care Safe medication use Reducing workload pressures Allowing pharmacists time for counseling Technicians increasing in number Responsibilities expanding Greater acceptance from pharmacists Greater recognition in state pharmacy practice acts Training length Pharmacy Technician Workforce High School entry diploma requirements Dental Assistant Medical Assistant Veterinary Technician Barbering & Cosmetology Up to 1 year 1 2 years 1 2 years 2 4 years Minimum of 9 months Post secondary non degree award High School diploma degree High School Diploma + State licensed program Source: ACPE analysis of Accrediting Commission of Career Schools & Colleges (ACCSC) directory (2003) Degree awarded Certificate/ Diploma/ Certificate/ Diploma Certificate/ Diploma/ degree/ Bachelors Source: Bureau of Labor Statistics (2012) degree 3

4 Demonstrate knowledge and skills Gain Trust of pharmacists and public Verify competency Skilled workforce Reduce Medication Errors Improve patient outcome PTCE ExCPT Organization PTCB (1995) NHA (2005) Type of organization Non-profit governed by: ASHP, APhA, NABP, Michigan Pharmacists Association, & Illinois Council of Health-System Pharmacists Private organization (administers variety of allied health certifications); governed by the Institute for Certification of Pharmacy Technicians (ICPT) Cost $129 $105 /$115 Length 2 hours, 90 Qs (10 pretest) 2 hours, 100 Qs (20 pretest) 18 years of age H.S. Diploma H.S. Diploma/GED No drug related No drug felonies felonies If have non-drug related Testing No felonies of any kind felony more than 7 years old, Requirements in the last 5 years may petition ICPT to take test PTCE ExCPT Passing Score (1400 Passing) (390 Passing) Every 2 years (no grace period) Every 2 years (with 90 day grace period) 20 hours CE required include 2 20 hours CE required include Recertification hours pharmacy law 1 hour pharmacy law Requirements Cost: $40 online or $50 paper Cost: $40 online or $50 paper Revocation For false statements, cheating, conviction of a crime or felony or moral turpitude (incl. but not limited to drug-related crimes), documented gross negligence, intentional misconduct or deficiency in knowledge base For false statements, cheating, conviction of a drug-related felony, revocation of registration/licensure by a state, documented violation of ICPT Code of Ethics a) H.S. diploma b) No drug related felonies c) Training certification from an ASHP accredited program d) 18 years of age Three general areas Regulations and technicians duties (~25%) Drugs and drug products (~23%) The dispensing process (~52%) Three functional areas Assisting the pharmacist in serving patients (~66%) Maintaining medication and inventory control systems (~22%) Participating in the administration and management of pharmacy practice (~12%) 4

5 Nine knowledge domains Pharmacology for Technicians (~13.75%) Pharmacy Law and Regulations (~12.5%) Sterile and Non-sterile Compounding (~8.75%) Medication Safety (~12.5%) Pharmacy Quality Assurance (~7.5%) Medication Order Entry and Fill Process (~17.5%) Pharmacy Inventory Management (~8.75%) Pharmacy Billing and Reimbursement (~8.75%) Pharmacy Information Systems Usage and Application (~10%) 45 states regulate pharmacy technicians and require state registration 26 states require certification In 5 states, eligibility to work is dependent on passing the PTCE PTCE is approved in 45 states and ExCPT is approved in 26 states About 7200 certified through ExCPT and 587,536 through the PTCE Consumer Awareness, Resources, Education, Sate Policy, and Testing (C.R.E.S.T) Summit Palm Beach, FL Feb , 2011 Address current issues Discuss profession Discuss future directions Decide on resource development C.R.E.S.T Summit Survey (>17,000) 84% - PTCB should create an advanced CPhT designation 83% - Agreed that pharmacy technicians have involvement in the implementation of the JCPP 2015 vision 81% - Identified pharmacy technicians as completing tasks to free up pharmacists time to dedicate to patient care and safety initiatives C.R.E.S.T Summit Recommendations Innovative roles for pharmacy technicians Improve regulatory and statutory requirements Single standards for education, training, certification, and regulatory oversight Additional certification and recertification requirements Advanced CPhT credential 5

6 PTCB Requirements under consideration (Future Vision) I- Certification 1. Minimum period of practical experience prior to testing 2. Criminal background check 3. Completion of ASHP- accredited training program ( deadline) PTCB Requirements under consideration (Future Vision) II- Recertification 1. Accept only pharmacy technician targeted continuing education (C.E.) 2. Require at least 15 of the 20 C.E.s to come from state BOP, NABP, employer-accredited programs, or Accreditation Council for Pharmacy Education (ACPE) accredited programs Limit employer based education to 5 hours Mandate at least 1 hour of C.E. in medication/patient safety PTCB Requirements under consideration (Future Vision) III- New Certification Programs 1. Develop certification programs in the areas of sterile compounding, technology, medication safety, regulatory compliance, medication therapy management, inventory management, and/or medication reconciliation 2. Advanced CPhT credential Joint Commission of Pharmacy Practitioners (JCPP) 2015 vision Pharmacists will be the health care professionals responsible for providing patient care that ensures optimal medication therapy outcomes. Standardizing Education & Training ASHP advocates that pharmacy technicians must be certified by the PTCB as a prerequisite to state licensure. The National Association of Boards of Pharmacy (NABP) and ASHP advocate that pharmacy techs become certified by the PTCB before being licensed or registered by state boards. NABP encourages Boards of Pharmacy to Require as an Element of Pharmacy Technician Certification Completion of an Education and Training Program by Current Pharmacy Technician Roles Inventory maintenance Computer data input Purchasing/inventory control Billing/insurance Assisting in prescription dispensing Prepackaging/repackaging Compounding non-sterile products Holding leadership roles/supervisory roles Compounding sterile products/i.v. admixtures Compounding radiopharmaceuticals 6

7 a) Insurance billing b) Inventory maintenance c) Sterile compounding d) All of the above Innovative Pharmacy Technician Roles Data Analysis Medication Therapy Management Clinical involvement Medication reconciliation Informatics Compliance /Regulatory Affairs Quality Assurance / Medication safety Tech-check-tech Program Director Chart Reviews Benchmarking surveys Financial impact analysis Initiative assessment Quality improvement reporting and graphing Patient risk assessment Data collection and interpretation Formulary enforcement Management of vaccination database Patient outreach after discharge Home visits / telephone follow-up Pharmacists extenders Obtain medication histories Assist in medication reconciliation Identify potential drug therapy problems Reinforce medication education Collect and document drug histories Identify patients requiring pharmaceutical input Identify and report adverse drug reactions Facilitate discharge planning Communicate with community pharmacies regarding any medication changes Near patient testing using capillary blood sampling Calculating warfarin doses Identify and report warning symptoms (bruising, etc.) Interview patients upon admission Collect accurate medication history Identify discrepancies Communicate with pharmacies and physician s offices Data entry Educate patients on services available to them Schedule patient home visits upon discharge Discrepancies evaluated by pharmacist Prepare compliance reports 7

8 Maintain / optimize technology Support pharmacy Information Systems Identify and resolve operational issues related to pharmacy information systems Train and educate end-users Coordinate and perform drug catalog maintenance in pharmacy computer systems Serve as point of contact for nursing on issues related to automated dispensing devices Perform Medication management audits Document and oversee compliance with policies and procedures Disseminate new information or policies and procedures to staff Perform and address process control audits of pharmacy operations and systems Train clinicians on medication management (storage, handling, &administration) High risk medication testing and tracking Perform environmental monitoring (air quality testing, media fill tests, glove tip testing, etc.) Document, train, and test staff Author and enforce cleanroom policies and cleaning procedures Understand USP regulations Generate monthly reports Track and analyze end product Quarantine program Coordinate recalls Authorized by pharmacy boards in at least 9 states Check the work of other technicians Drug order entry Perform order verification on medication refills Education and training required Ongoing quality assurance tests Develop and implement training program Manage and implement program budget Interview, train, develop, manage and lead faculty Ensure compliance with state and federal regulations Establish and maintain advisory committees Evaluate viability of new course requests and modification of existing courses a) Tech-check-tech b) Medication dispensing technician c) Medication safety management d) Medication reconciliation 8

9 Medication Safety Future Vision Pharmacy technician education and training is important in saving lives Pharmacy technicians are the 2 nd barrier to preventing medication errors in pharmacy Increasing job satisfaction and retention The future is in your hands Questions? History of ASHP activities for technicians: White paper on pharmacy technician 2002: ICPT Certification Exam Receives NCCA Accreditation: PTCB C.R.E.S.T initiative: &Template=/CM/HTMLDisplay.cfm&ContentID=4734 PTCB Considers Changes to Certification, Recertification: d=3587 How to Become a Barber, Hairdresser, or Cosmetologist, Bureau of Labor Statistics: Service/Barbers-hairdressers-and-cosmetologists.htm#tab-4 Pharmacy technician Career Description, American Medical Association. ExCPT Candidate s Handbook: sflb.ashx PTCB Revocation of Certification, 2009: ation&template=/cm/contentdisplay.cfm&contentid=3313 PTCB C.R.E.S.T initiative: &Template=/CM/HTMLDisplay.cfm&ContentID=4734 PTCB 2011 C.R.E.S.T Summit Proceedings: mplate=/cm/contentdisplay.cfm&contentid=4231 ASHP Statement on the roles of pharmacy technicians: Statement-on-the-Roles-of-Pharmacy-Technicians.aspx National Association of Boards of Pharmacy. Report of the Task Force on Standardized Pharmacy Technician Education and Training (September 2009). Available at: h_educ_training.pdf (accessed 2015 Sep 4). Pharmacy Technician Education Task Force: Data Analyst Technician: 9